Medical homes’ urged by reformers

Dean Olsen

Tuesday

Feb 24, 2009 at 12:01 AMFeb 24, 2009 at 7:28 PM

With Congress and President Barack Obama poised to enact major health-care reforms, citizens should encourage politicians to support the concept of comprehensive “medical homes,” several Springfield doctors said at a health-care forum Monday night.

With Congress and President Barack Obama poised to enact major health-care reforms, citizens should encourage politicians to support the concept of comprehensive “medical homes,” several Springfield doctors said at a health-care forum Monday night.

The idea would improve care for patients, reverse some negative health trends and persuade more doctors to practice primary-care medicine rather than enter higher-paying specialties, said Dr. Jerry Kruse, chairman of family and community medicine at Southern Illinois University School of Medicine.

But Kruse said progress toward medical homes could be quashed by a sagging economy.

“American medicine stands at an unparalleled time of opportunity and an unparalleled time of peril at the same time,” he said.

Speaking at a public forum presented by the Citizens Club of Springfield, Kruse was joined in endorsing the medical-home idea by Dr. Janet Albers, director of SIU’s Springfield family medicine residency program, and Dr. Jim Dove, founder of the Prairie Cardiovascular physician group.

The concept involves a physician — usually a primary-care doctor, but sometimes a specialist, such as a cardiologist — providing more comprehensive care, education and coordination of services than what usually occurs. The additional services are provided by a team of doctors, nurses and other health-care workers, but the concept needs funding for that team to work.

“There has to be a grass-roots effort ... for something to occur,” Kruse said in front of an audience of about 60 people at St. John’s Hospital’s Dove Conference Center.

Dove said the concept has major supporters on Capitol Hill. Kruse said the medical-home approach could save health care dollars through greater efficiency. Dove wasn’t convinced the concept would save money, but said it would provide better care.

“We want to move to the best system that we can develop,” Dove said.

The current U.S. system costs more than $2 trillion a year. It is the most expensive per capita in the world, but doesn’t lead to the best overall results, Albers said.

At the same time, 47 million people — 15.8 percent of the population — are uninsured and often delay care because of costs, she said.

In Sangamon County, an estimated 26,000 people have no health insurance, Kruse said.

He said the number of American women getting mammograms and pap smears to be screened for breast and cervical cancer, respectively, has been on the decline since 2000, in large part because of the growing number of uninsured and under-insured.

Dove said insurance industry bureaucracy, excess profits in the pharmaceutical industry and unnecessary tests and procedures ordered by doctors fearful of malpractice lawsuits waste an estimated $390 billion each year. He said antitrust law also needs to be changed to allow more cooperation among health-care providers.

But he said Americans shouldn’t abandon the good parts of the current system and noted that death rates from heart disease and stroke have dropped dramatically in recent decades.